Reproductive Hormone Levels and Anthropometry in Postmenopausal Women with Polycystic Ovary Syndrome (PCOS): A 21-Year Follow-Up Study of Women Diagnosed with PCOS around 50 Years Ago and Their Age-Matched Controls

Schmidt, Jan Peter; Brännström, Mats; Landin‐Wilhelmsen, Kerstin; Dahlgren, Eva

doi:10.1210/jc.2010-2959

Cited by 92 publications

(123 citation statements)

References 31 publications

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“…In PCOS, after a steady decrease with age until menopause, the FAI and cFT seemed to increase after the age of 50 years, although with great individual variation. This is in line with the results of previous studies in which it has been suggested that hyperandrogenemia persists or even worsens after menopause in women with PCOS (20,(35)(36)(37). We speculate that the elevation and individual variation of the androgen parameters are probably linked to the significant decrease in SHBG levels, which in turn is linked to increased weight, impaired glucose metabolism, and insulin sensitivity in some of the subjects, as shown in previous studies (19,23,38,39).…”

Section: Discussionsupporting

confidence: 93%

“…The strengths of our study are as follows: 1) it covered a large study population including women with PCOS from young fertile age to menopause, the age window being wider than in earlier studies (20,30,33,37); 2) the study population was homogeneous because all women were Caucasians; and 3) we used the gold standard of analysis, liquid chromatography-mass spectrometry, for the assay of T in all subjects. The PCOS cohorts were recruited from five different study sites, but at all sites the Rotterdam criteria for PCOS was used.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Androgen Profile Through Life in Women With Polycystic Ovary Syndrome: A Nordic Multicenter Collaboration Study

Pinola

Piltonen

Puurunen

et al. 2015

The Journal of Clinical Endocrinology & Metabolism

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Context: Women with polycystic ovary syndrome (PCOS) have increased androgen secretion throughout fertile life; however, the data on the effect of menopause on hyperandrogenemia in these women are scarce. Nevertheless, large comprehensive comparative studies on age-related androgen levels in women with PCOS are lacking. Objective:The objective of the study was to investigate the effect of age on serum androgen levels in women with PCOS and to determine cutoff values for androgens and SHBG associated with a PCOS diagnosis.Design: This was a case-control study. Setting:The study was conducted in five university sites in the Nordic countries.Patients: In all, 681 women with PCOS and 230 referent women were grouped according to age into seven age groups (18 to Ͼ 50 y).Interventions: There were no interventions.Main Outcome measures: T, SHBG, free androgen index (FAI), calculated free T (cFT), androstenedione (A4), and dehydroepiandrosterone sulfate were measured.Results: Androgen levels in women with PCOS decreased with age toward menopause. The difference between women with PCOS and the referent women narrowed and individual variation increased as they approached menopause. T levels, FAI, and cFT were significantly higher in women with PCOS aged 18 -44 years (P Ͻ .001, adjusted for body mass index). The best predictive factors for having PCOS were cFT (Ն0.40 ng/dL, odds ratio [OR] 7.90), FAI (Ն2.0, OR 6.71), and A4 (Ն277.94 ng/dL, OR 6.16). Conclusions:Women with PCOS had elevated serum androgen levels also after menopause. The parameters that best predicted PCOS at all ages were cFT, A4, and FAI. (J Clin Endocrinol Metab 100: 3400 -3407, 2015)

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Androgen Profile Through Life in Women With Polycystic Ovary Syndrome: A Nordic Multicenter Collaboration Study

Pinola

Piltonen

Puurunen

et al. 2015

The Journal of Clinical Endocrinology & Metabolism

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“…This is aggravated if a woman has diabetes and dyslipidemia [20]. On the other hand, another study indicates that these patients had fewer climacteric symptoms than controls [21], further have insulin resistance attenuated. But, there were reports that did not find differences between postmenopausal patients with or without pre-polycystic ovary syndrome [22].…”

Section: Metabolic Disorders During Menopausementioning

confidence: 99%

Possible Role of Nrf2 in Oxidative and Inflammatory Processes During Menopause

Mendoza¹,

Zamarripa²,

Hernández³

et al. 2016

A Master Regulator of Oxidative Stress - The Transcription Factor Nrf2

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The increase in life expectancy leads to the possibility of development chronic diseases, from special physiological conditions as occurs in the menopause, which is defined as the permanent cessation of ovulation, marked by the end of menstruation. It has been related to decreased ovarian function that occurs around an age of 45 years. This event involves the reduction in estrogen production and may contribute to the development of chronic-degenerative diseases. Many diseases developed during menopause have been associated with oxidative stress, such as osteoporosis, hot flushes, cognitive impairment, insulin resistance, dry skin, obesity, and cardiovascular events. The knowledge about the participation of Nrf2 in diseases that occur during menopause is very limited. Here, only diseases such as osteoporosis, cardiovascular diseases and dry skin, which are present during menopause and its later stages have been described. The Nrf2 pathway involves the participation of PI3K/Akt, MAPK, and eNOS, which act as mediators for cytoprotection and antioxidation. Compounds such as equol, fitoestrogens, alkyl cathecols, or curcumin could be offered as options to antioxidant treatment, added the fact that they are present in fruits and vegetables which are rich in vitamins, minerals and calcium, thus including all the required nutrients for an adequate nutrition.

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“…In women with PCOS, symptoms usually start in adolescence and gradually progress during reproductive years (24), with their severity depending on the presence of IR and obesity that is also associated with an increased risk for metabolic abnormalities (25). Although in perimenopause there is an amelioration of the clinical and laboratory features of PCOS (26,27), elevated androgen levels of both ovarian and adrenal origin continue to persist during early postmenopause (14) and remain elevated up to late menopause without exceeding premenopausal levels (28). Although other androgens such as androstanediol glucuronide may also be implicated particularly in the development of hirsutism, there is no data on their potential effect in postmenopausal women with PCOS (29).…”

Section: Polycystic Ovary Syndromementioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Hyperandrogenism after menopause

Markopoulos

Kassi

Alexandraki

et al. 2015

European Journal of Endocrinology

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Postmenopausal hyperandrogenism is a state of relative or absolute androgen excess originating from either the adrenals and/or the ovaries, clinically manifested as the appearance and/or increase in terminal hair growth or the development of symptoms/signs of virilization. In either settings, physicians need to evaluate such patients and exclude the presence of the relatively rare but potentially life-threatening underlying tumorous causes, particularly adrenal androgen-secreting tumors. It has been suggested that the rapidity of onset along with severity of symptom and the degree of androgen excess followed by relevant imaging studies may suffice to identify the source of excessive androgen secretion. However, up to date, there is no consensus regarding specific clinical and hormonal indices and/or imaging modalities required for diagnostic certainty. This is particularly relevant as the aging population is increasing and more cases of postmenopausal women with clinical/biochemical evidence of hyperandrogenism may become apparent. Furthermore, the long-term sequels of nontumorous hyperandrogenism in postmenopausal women in respect to cardiovascular morbidity and mortality still remain unsettled. This review delineates the etiology and pathophysiology of relative and absolute androgen excess in postmenopausal women. Also, it attempts to unravel distinctive clinical features along with specific hormonal cut-off levels and/or appropriate imaging modalities for the facilitation of the differential diagnosis and the identification of potential long-term sequels.

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Reproductive Hormone Levels and Anthropometry in Postmenopausal Women with Polycystic Ovary Syndrome (PCOS): A 21-Year Follow-Up Study of Women Diagnosed with PCOS around 50 Years Ago and Their Age-Matched Controls

Cited by 92 publications

References 31 publications

Androgen Profile Through Life in Women With Polycystic Ovary Syndrome: A Nordic Multicenter Collaboration Study

Androgen Profile Through Life in Women With Polycystic Ovary Syndrome: A Nordic Multicenter Collaboration Study

Possible Role of Nrf2 in Oxidative and Inflammatory Processes During Menopause

MANAGEMENT OF ENDOCRINE DISEASE: Hyperandrogenism after menopause

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